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Medical treatment of Diabetes. There are two types of diabetes. In Type 1 diabetes there is total absence of Insulin production. Hence life is dependent on Insulin for these patients. The patient gets very sick, if the insulin is not taken for a couple of days. Usually we use two types of insulin. A basal insulin which takes care of the daily metabolism of the patient and a meal time bolus to cover the rise in sugar with meals. Once we figure out how much the patient needs, we have to adjust their doses depending on type and quantity of diet and exercise. Type II diabetes which accounts for 95% of diabetes patients, is an insulin resistant state with a relative decrease in insulin production in the presence of insulin resistance. Most doctors are inclined to treat this as a sugar diabetes problem. As a result are caught up in chasing the sugar with insulin or Sulphonylureas drugs. But this is a silent vascular disease and a “silent killer”. This is a complex metabolic disease. It is a combination of 4 major abnormality often referred to as the “terrible quartet” comprising of central obesity, high blood sugar, high blood pressure and a complex cholesterol abnormality. It is pivotal in type II diabetes; we address all four problems simultaneously. In order for the patient to do well, we must look at the patient holistically. Doctors need to assess the blood pressure, pattern of Cholesterol abnormality and fix their insulin resistance. Chasing the sugar, is a myopic approach to sugar control and increase in weight. Patients continue to gain weight and we keep increasing the dose of the medicines. Finally the patient is put on insulin and the patient never succeeds but continues to being a victim of diabetes and continues to have vascular events like, vision deterioration, stroke, heart attacks, kidney failure and amputation of the limbs. But today we have good medicines for insulin resistance, vascular-protection, cardio-protection, eye protection and kidney protection. Patient can be helped with good and appropriate treatment to become a “victor” and have hope of a better tomorrow. The doctor must spend the time to listen and assess the patients needs and a customized approach of medical management can reduce complications and perhaps reverse some of the complications that have already happened. Diet and exercise and life style modification will always play a pivotal role in the final outcome. For more information please visit www.diabeteshypertension.com. Dr Narendra K Gupta, best diabetes doctor in Gurgaon and Delhi
Diabetes & blood glucose control There are several factors in glucose control in diabetes. One of them is self glucose monitoring at home. This is not educated to patients, but is an important way to keep a track of where is our diabetes going. Is it well controlled and whether certain types of food affect our blood glucose. It is a way to learn what foods have what kind of foods have what kind of effect. It is also important to remember that the blood sugar is highest in the morning. So the first blood sugar check is a good way to look at the worst fasting blood sugar. Best Diabetes doctor in Delhi, India.
Diabetes is of two types. In type I diabetes, there is total absence of Insulin and hence the blood sugar derangement, quite extreme. It forms 3-5% of Diabetic cases. Whereas, type II diabetes is much more common and rapidly increasing. We have a tendency to think, it is a disease of blood sugar. It is an “insulin resistant” state and even though insulin is produced, it is not enough to control the blood sugar. This is a slowly progressive disease and it takes 12-18 years for one to become diabetic. It is a vascular disease that is a “Silent Killer” and is the most common cause of blindness, heart disease, stroke, kidney failure and amputation.
Diabetes is of two types. In type I diabetes, there is total absence of Insulin and hence the blood sugar derangement, quite extreme. It forms 3-5% of Diabetic cases. Whereas, type II diabetes is much more common and rapidly increasing. We have a tendency to think, it is a disease of blood sugar. It is an “insulin resistant” state and even though insulin is produced, it is not enough to control the blood sugar. This is a slowly progressive disease and it takes 12-18 years for one to become diabetic. It is a vascular disease that is a “Silent Killer” and is the most common cause of blindness, heart disease, stroke, kidney failure and amputation. Type II diabetes is a complex metabolic disorder, where weight gain around the belly button, high cholesterol, high blood pressure and high blood sugar coexists in the same patient. Hence the term, “Terrible Quartet”. It is a different disease in men and women. In men it is associated with male menopause or Andropause. There is male pattern baldness, weight gain, muscle wasting, sexual dysfunction and mental irritability and anger. In female it causes Polycystic Ovarian Syndrome PCOD. This is associated with increase hair growth all over the body, pimples (Acne), obesity, male facial changes, irregular menstrual cycle and infertility. This is rapidly growing in young girls, specially in counties like Indian Subcontinent and Chine. Diabetes is a disease of rapid aging called Progeria. So at the age of 40 one becomes like 50 and at 50 like 65. But the good news today is that every complication of diabetes are reversible, if treated appropriately. People can aspire to not only have a good quality of life but, live even longer than those who do not have diabetes. Best diabetes doctor in Gurgaon. Best Diabetes doctor in Delhi.
Diabetes is of two types. In type I diabetes, there is total absence of Insulin and hence the blood sugar derangement, quite extreme. As a result they will get admitted to hospital at the time of diagnosis. Insulin injections are a life savior and a must. They require a long acting insulin called basal insulin and a meal time short acting insulin. It forms 3-5% of Diabetic cases. Best diabetes doctor. Best hypertension doctor.
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